Boytsov S A, Andreev E M, Samorodskaya I V
National Research Center for Preventive Medicine, Moscow, Russia.
Center for Demographical Studies Research at the New Economic School, Moscow, Russia.
Kardiologiia. 2017 Jan(1):5-16.
to compare and discuss causes of differences between standardized mortality rates (SMR) from diseases of the circulatory system (DCS) among men and women older than 50 years in Russia and USA.
Data on mortality rate in the USA were taken from WHO mortality database (WHO MD), those on the USA population by 5-years age bands from Human Mortality Database (HMD). Information on mortality rates in Russia was obtained from Rosstat. In analysis we used age-adjusted death rates and SMR for DCS or ages more or equal 50 years. For standardization of mortality rates we used data of the European Standard Population 2013.
By 23 3-digit codes mortality rates among men in USA were higher than in Russia (in the structure of mortality among women there were 28 such codes). Portion of such deaths in Russia in total number of DCS deaths was 6.5% both for men and women, while figures for USA were 36.8 and 40%, respectively. About 99% of differences in SMR from DCS between countries were determined by 8 and 6 groups of causes in men and women, respectively. Analysis of 4-digit ICD codes showed that almost 40% of DSC class deaths both in Russia and USA had the forth digit of ICD-10 code 8 or 9 and were accompanied by wording "other" or "unspecified" or formulation of diseases which were not used in clinical practice and were absent in both guidelines issued by Russian or American professional societies. Despite existence of ICD rules the conducted analysis allows to state that those rules could be interpreted differently in various countries. This resulted in obtaining noncomparable data.
Comparison of mortality rates in USA and Russia based on existing ICD coding rules cannot be correctly performed. Therefore, this comparison does not allow to assess contribution of financing and organization of medical service in differences in mortality rates between two countries.
比较并探讨俄罗斯和美国50岁以上男性和女性循环系统疾病（DCS）标准化死亡率（SMR）差异的原因。
美国死亡率数据取自世界卫生组织死亡率数据库（WHO MD），5岁年龄组的美国人口数据取自人类死亡率数据库（HMD）。俄罗斯死亡率信息来自俄罗斯联邦统计局。分析中我们使用了年龄调整死亡率以及50岁及以上DCS的SMR。为了标准化死亡率，我们使用了2013年欧洲标准人口数据。
按23个三位编码，美国男性死亡率高于俄罗斯（女性死亡率结构中有28个此类编码）。俄罗斯此类死亡在DCS死亡总数中的占比，男性和女性均为6.5%，而美国的数字分别为36.8%和40%。各国间DCS的SMR差异约99%分别由男性的8组和女性的6组病因决定。对四位ICD编码的分析表明，俄罗斯和美国几乎40%的DSC分类死亡的ICD - 10编码第四位为8或9，且伴有“其他”或“未指明”字样，或为临床实践中未使用且俄罗斯或美国专业协会发布的指南中均未出现的疾病表述。尽管存在ICD规则，但所进行的分析表明这些规则在不同国家可能有不同解释。这导致获得不可比的数据。
基于现有ICD编码规则无法正确比较美国和俄罗斯的死亡率。因此，这种比较无法评估医疗服务融资和组织对两国死亡率差异的影响。
